Individual
JOHN W HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001118
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000548502
—
PA
01
—
15486
GELSINGER HEALTH PLAN
—
01
—
410024728
RAILROAD MEDICARE
—
01
—
506554
AETNA
—
01
—
HU289290
HIGH MARK BLUE SHIELD
—
Enumeration date
08/13/2006
Last updated
01/08/2010
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